Authors Catalyst Center , National Coordinating Center for the Regional Genetics Networks
Keywords CYSHCN, Financing
In April, May, and June of 2022, the Catalyst Center and the National Coordinating Center for the Regional Genetics Networks, two programs supported by the Health Resources and Services Administration (HRSA), hosted a three-part webinar series to help the genetics community and other interested parties better understand how to navigate medical necessity and the prior authorization process. The webinars utilize a therapeutic case study as well as family and provider perspectives.
Part one of the series explores the definition of medical necessity and shows how evidence is used to help inform medical necessity criteria and policy.
Part two discusses EPSDT, the Title V and Medicaid relationship, and defines the first steps in the process of getting prior authorization for medically necessary services.
Part three provides a practical application of medical necessity, including understanding the prior authorization process, requesting authorizations, and navigating denials and appeals.
Click below to access the recordings, slides, and Q&A from each of the three webinars.
If you are interested in Continuing Medical Education (CME) credits The Medical Necessity Webinar Series is also available through the Genetics Academy, until May 31, 2024. Credits offered include: 3 CME (AMA) Credits, 3 CME (Other) Credits, and 3 Certificate of Participation Credits. Please see the course page on the Genetics Academy website for more information.